This is an excerpt from Second Opinion, a weekly roundup of health and medical science news emailed to subscribers every Saturday morning. If you haven’t subscribed yet, you can do that by clicking here.
New Canadian data suggests the bold strategy to delay and mix second doses of COVID-19 vaccines led to strong protection from infection, hospitalization and death — even against the highly contagious delta variant — that could provide lessons for the world.
Preliminary data from researchers at the British Columbia Centre for Disease Control (BCCDC) and the Quebec National Institute of Public Health (INSPQ) shows the decision to vaccinate more Canadians sooner by delaying second shots by up to four months saved lives.
The researchers excluded long-term care residents from the data, who are generally at increased risk of hospitalization and death from COVID-19, in order to get a better sense of vaccine effectiveness in the general population — and the results were exceptional.
The analysis of close to 250,000 people in B.C. from May 30 to Sept. 11 found two doses of any of the three available COVID-19 vaccines in Canada were close to 95 per cent effective against hospitalization — regardless of the approved vaccination combination.
That means for every 100 unvaccinated people severely ill in Canadian hospitals, 95 of them could have been prevented by receiving two doses of either the AstraZeneca-Oxford, Pfizer-BioNTech and Moderna vaccines, or some combination of the three.
Dr. Danuta Skowronski with the B.C. Centre for Disease Control laid the groundwork for the decision to hold back second doses and says the early vaccine effectiveness data is extremely encouraging. (Harman/CBC)
Dr. Danuta Skowronski, a vaccine effectiveness expert and epidemiology lead at the BCCDC whose research laid the groundwork for the decision to hold back second doses based on the “fundamental principles of vaccinology,” says the early data is extremely encouraging.
“We were very pleased to see during the period when the delta variant was not just circulating, but predominating, that we had such high protection nonetheless against both infection and hospitalization,” the lead researcher on the analysis told CBC News.
“Protection was even stronger when the interval between the first and the second doses was more than six weeks apart.”
In fact, the research showed that protection against COVID-19 infection from two doses of the Pfizer vaccine rose dramatically when the first and second shots were spread out — from 82 per cent after three or four weeks, to 93 per cent after four months.
“For those who received the AstraZeneca vaccine as their first dose, their protection against any infection was lower than for mRNA vaccine recipients, but they had comparable protection against hospitalization and that’s the main goal,” she said.
“But for those who received a first dose of AstraZeneca and a second dose as an mRNA vaccine, their protection was as good as those who had received two mRNA vaccines. So that’s also a really important finding from this analysis.”
While the work is still being finalized and has not yet been submitted as a pre-print or undergone peer review, the researchers felt it’s important to get their early data out now to inform the public and policymakers here and abroad about the positive results.
“The mix-and-match schedules are protecting well, and my preference would be that those countries who don’t recognize that get to see our data as soon as possible,” she said, adding that the findings were sent to U.S. officials for review of international travel policies.
“My hope is that when they see the evidence that they will change those policies, which are frankly inconsistent with the science.”
Quebec data backs up findings from B.C.
In Quebec, thousands of kilometres away and with a different population, demographic makeup and early vaccine rollout approach — the results of a twin study that will be published alongside the B.C. data were astonishingly similar.
Of the 181 people who died from COVID-19 from May 30 to Sept. 11 in Quebec, just three were fully vaccinated. Researchers say that corresponds to a vaccine effectiveness against death upwards of 97 per cent based on a population analysis of nearly 1.3 million people.
Similar to the B.C. data, the Quebec research also showed more than 92 per cent protection from hospitalizations — with Pfizer, Moderna or AstraZeneca vaccines — against all circulating coronavirus variants of concern in Canada at that time, including delta.
“The takeaway is whatever vaccine people had, if they got two doses they should consider that they are very well protected against severe COVID-19,” said Dr. Gaston De Serres, an epidemiologist at the INSPQ. “That’s the main message.”
The analysis found Pfizer and Moderna vaccines were 90 per cent effective at preventing COVID-19 infections — either asymptomatic, symptomatic, or those needing hospital care — a protection rate equal to those with an AstraZeneca and mRNA vaccine combination.
For people who received two doses of AstraZeneca, the research suggests a slightly lower level of protection from infection — but one that is still remarkably high at 82 per cent.
The research showed that protection against COVID-19 infection from two doses of the Pfizer vaccine rose dramatically when the first and second shots were spread out. (Darryl Dyck/The Canadian Press)
De Serres says the National Advisory Committee on Immunization (NACI) and the Quebec Immunization Committee (CIQ) are looking at whether additional doses may be needed for that group, but says it’s “not as pressing” given the strong protection from hospitalization.
“For the time being, just stay put. If there is a recommendation for you to get an additional RNA dose you’ll know in time,” De Serres said. “But feel that what you’ve got is still a very good regimen to protect you against what we fear most — which is severe COVID-19.”
The NACI recommendation in March to delay second doses of all three COVID-19 vaccines by up to four months was not without controversy at the time, and no doubt led to confusion among many Canadians about whether they were adequately protected.
Canada’s Chief Science Adviser Mona Nemer said in early March that the strategy amounted to a “population level experiment,” while at the same time health officials tried to reassure the public that the approach was safe and effective.
Deepta Bhattacharya, an immunologist at the University of Arizona who was not involved in the study, says the results are “very encouraging” and provide evidence of “improved real world protection” from delaying second doses.
But he admits even he was initially skeptical.
“I was uneasy about it in large part because I just wasn’t sure how well the protection would hold up in the interim,” he said. “Obviously it turned out well … but it was risky, and that gamble paid off.”
Bhattacharya says the Canadian data now provides real world evidence that vaccinated people produce more antibodies if their second shot is delayed, and the quality of those antibodies may actually improve — which could explain the better protection against delta.
“What I’m really wondering now going forward is whether the recommendations are going to fundamentally change as to when we should get that second shot,” he said, referring to other countries around the world. “I wish I’d gotten mine later now in retrospect.”
Keeping ‘eye on the prize’ means avoiding hospitalization
The data also has implications on whether average Canadians need booster shots, particularly given that emerging real world data in other countries like the U.S., Israel and Qatar show evidence of waning immunity that has prompted the rollout of third doses.
But experts caution that while countries reporting diminished vaccine effectiveness against COVID-19 infection may be making headlines, the more important factor is that the studies largely show the vaccines have prolonged protection against severe COVID-19 — meaning hospitalization and death.
“We really should keep our eyes on the prize, which is preserving healthcare system capacity and preventing unnecessary suffering,” said Skowronski. “We’re not going to prevent every case of COVID-19. Our goal was never to prevent the sniffles. Our goal was to prevent serious outcomes.”
Still, the B.C. and Quebec data showed “no signs” of waning immunity in the general population four months after the second mRNA dose and strong protection against infection of more than 80 to 90 per cent maintained. The analysis doesn’t go beyond five months, but the researchers will continue monitoring vaccine effectiveness.
“We should be reassured that our vaccine effectiveness from this calculation, from what I’ve seen, will be robust with its protection,” said Alyson Kelvin, an assistant professor at Dalhousie University and virologist at the Canadian Center for Vaccinology and the Vaccine and Infectious Disease Organization in Saskatoon who was not involved in the research.
“We must continue to have public health measures in place as well as expect at some point we might need a booster, but data like this will inform when we do and right now it’s suggesting that we don’t need it yet — but we have to keep vigilant.”
WATCH | Canada recommends COVID-19 booster shots for long-term care residents:
NACI recommends COVID-19 booster shots for seniors in long-term care
10 days ago
Amid a global debate over COVID-19 vaccine boosters, the National Advisory Committee on Immunization is recommending third doses for Canada’s most vulnerable, especially seniors in long-term care homes. 1:58
Skowronski says that while she supports giving long-term care residents and immunocompromised people third doses of COVID-19 vaccines to increase their protection based on emerging data, including from Canada, there isn’t enough evidence yet for average Canadians.
Until then, she says Canadians should feel well protected against severe outcomes from COVID-19 in the delta-driven fourth wave if they’re fully vaccinated with any of the approved vaccine combinations in Canada.
“We’re going to have to learn to live with SARS-CoV-2, including in it’s very many future iterations,” she said.
“But so long as we can prevent severe outcomes and maintain healthcare system capacity, we can come to a kind of a mutual understanding with this virus.”
Skinstitut Holiday Gift Kits take the stress out of gifting
Toronto, October 31, 2024 – Beauty gifts are at the top of holiday wish lists this year, and Laser Clinics Canada, a leader in advanced beauty treatments and skincare, is taking the pressure out of seasonal shopping. Today, Laser Clincs Canada announces the arrival of its 2024 Holiday Gift Kits, courtesy of Skinstitut, the exclusive skincare line of Laser Clinics Group.
In time for the busy shopping season, the limited-edition Holiday Gifts Kits are available in Laser Clinics locations in the GTA and Ottawa. Clinics are conveniently located in popular shopping centers, including Hillcrest Mall, Square One, CF Sherway Gardens, Scarborough Town Centre, Rideau Centre, Union Station and CF Markville. These limited-edition Kits are available on a first come, first served basis.
“These kits combine our best-selling products, bundled to address the most relevant skin concerns we’re seeing among our clients,” says Christina Ho, Senior Brand & LAM Manager at Laser Clinics Canada. “With several price points available, the kits offer excellent value and suit a variety of gift-giving needs, from those new to cosmeceuticals to those looking to level up their skincare routine. What’s more, these kits are priced with a savings of up to 33 per cent so gift givers can save during the holiday season.
There are two kits to select from, each designed to address key skin concerns and each with a unique theme — Brightening Basics and Hydration Heroes.
Brightening Basics is a mix of everyday essentials for glowing skin for all skin types. The bundle comes in a sleek pink, reusable case and includes three full-sized products: 200ml gentle cleanser, 50ml Moisture Defence (normal skin) and 30ml1% Hyaluronic Complex Serum. The Brightening Basics kit is available at $129, a saving of 33 per cent.
Hydration Heroes is a mix of hydration essentials and active heroes that cater to a wide variety of clients. A perfect stocking stuffer, this bundle includes four deluxe products: Moisture 15 15 ml Defence for normal skin, 10 ml 1% Hyaluronic Complex Serum, 10 ml Retinol Serum and 50 ml Expert Squalane Cleansing Oil. The kit retails at $59.
In addition to the 2024 Holiday Gifts Kits, gift givers can easily add a Laser Clinic Canada gift card to the mix. Offering flexibility, recipients can choose from a wide range of treatments offered by Laser Clinics Canada, or they can expand their collection of exclusive Skinstitut products.
Brightening Basics 2024 Holiday Gift Kit by Skinstitut, available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.
Hydration Heroes 2024 Holiday Gift Kit by Skinstitut – available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.
LONDON (AP) — Most people have accumulated a pile of data — selfies, emails, videos and more — on their social media and digital accounts over their lifetimes. What happens to it when we die?
It’s wise to draft a will spelling out who inherits your physical assets after you’re gone, but don’t forget to take care of your digital estate too. Friends and family might treasure files and posts you’ve left behind, but they could get lost in digital purgatory after you pass away unless you take some simple steps.
Here’s how you can prepare your digital life for your survivors:
Apple
The iPhone maker lets you nominate a “ legacy contact ” who can access your Apple account’s data after you die. The company says it’s a secure way to give trusted people access to photos, files and messages. To set it up you’ll need an Apple device with a fairly recent operating system — iPhones and iPads need iOS or iPadOS 15.2 and MacBooks needs macOS Monterey 12.1.
For iPhones, go to settings, tap Sign-in & Security and then Legacy Contact. You can name one or more people, and they don’t need an Apple ID or device.
You’ll have to share an access key with your contact. It can be a digital version sent electronically, or you can print a copy or save it as a screenshot or PDF.
Take note that there are some types of files you won’t be able to pass on — including digital rights-protected music, movies and passwords stored in Apple’s password manager. Legacy contacts can only access a deceased user’s account for three years before Apple deletes the account.
Google
Google takes a different approach with its Inactive Account Manager, which allows you to share your data with someone if it notices that you’ve stopped using your account.
When setting it up, you need to decide how long Google should wait — from three to 18 months — before considering your account inactive. Once that time is up, Google can notify up to 10 people.
You can write a message informing them you’ve stopped using the account, and, optionally, include a link to download your data. You can choose what types of data they can access — including emails, photos, calendar entries and YouTube videos.
There’s also an option to automatically delete your account after three months of inactivity, so your contacts will have to download any data before that deadline.
Facebook and Instagram
Some social media platforms can preserve accounts for people who have died so that friends and family can honor their memories.
When users of Facebook or Instagram die, parent company Meta says it can memorialize the account if it gets a “valid request” from a friend or family member. Requests can be submitted through an online form.
The social media company strongly recommends Facebook users add a legacy contact to look after their memorial accounts. Legacy contacts can do things like respond to new friend requests and update pinned posts, but they can’t read private messages or remove or alter previous posts. You can only choose one person, who also has to have a Facebook account.
You can also ask Facebook or Instagram to delete a deceased user’s account if you’re a close family member or an executor. You’ll need to send in documents like a death certificate.
TikTok
The video-sharing platform says that if a user has died, people can submit a request to memorialize the account through the settings menu. Go to the Report a Problem section, then Account and profile, then Manage account, where you can report a deceased user.
Once an account has been memorialized, it will be labeled “Remembering.” No one will be able to log into the account, which prevents anyone from editing the profile or using the account to post new content or send messages.
X
It’s not possible to nominate a legacy contact on Elon Musk’s social media site. But family members or an authorized person can submit a request to deactivate a deceased user’s account.
Passwords
Besides the major online services, you’ll probably have dozens if not hundreds of other digital accounts that your survivors might need to access. You could just write all your login credentials down in a notebook and put it somewhere safe. But making a physical copy presents its own vulnerabilities. What if you lose track of it? What if someone finds it?
Instead, consider a password manager that has an emergency access feature. Password managers are digital vaults that you can use to store all your credentials. Some, like Keeper,Bitwarden and NordPass, allow users to nominate one or more trusted contacts who can access their keys in case of an emergency such as a death.
But there are a few catches: Those contacts also need to use the same password manager and you might have to pay for the service.
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Is there a tech challenge you need help figuring out? Write to us at onetechtip@ap.org with your questions.
The Canadian Paediatric Society says doctors should regularly screen children for reading difficulties and dyslexia, calling low literacy a “serious public health concern” that can increase the risk of other problems including anxiety, low self-esteem and behavioural issues, with lifelong consequences.
New guidance issued Wednesday says family doctors, nurses, pediatricians and other medical professionals who care for school-aged kids are in a unique position to help struggling readers access educational and specialty supports, noting that identifying problems early couldhelp kids sooner — when it’s more effective — as well as reveal other possible learning or developmental issues.
The 10 recommendations include regular screening for kids aged four to seven, especially if they belong to groups at higher risk of low literacy, including newcomers to Canada, racialized Canadians and Indigenous Peoples. The society says this can be done in a two-to-three-minute office-based assessment.
Other tips encourage doctors to look for conditions often seen among poor readers such as attention-deficit hyperactivity disorder; to advocate for early literacy training for pediatric and family medicine residents; to liaise with schools on behalf of families seeking help; and to push provincial and territorial education ministries to integrate evidence-based phonics instruction into curriculums, starting in kindergarten.
Dr. Scott McLeod, one of the authors and chair of the society’s mental health and developmental disabilities committee, said a key goal is to catch kids who may be falling through the cracks and to better connect families to resources, including quicker targeted help from schools.
“Collaboration in this area is so key because we need to move away from the silos of: everything educational must exist within the educational portfolio,” McLeod said in an interview from Calgary, where he is a developmental pediatrician at Alberta Children’s Hospital.
“Reading, yes, it’s education, but it’s also health because we know that literacy impacts health. So I think that a statement like this opens the window to say: Yes, parents can come to their health-care provider to get advice, get recommendations, hopefully start a collaboration with school teachers.”
McLeod noted that pediatricians already look for signs of low literacy in young children by way of a commonly used tool known as the Rourke Baby Record, which offers a checklist of key topics, such as nutrition and developmental benchmarks, to cover in a well-child appointment.
But he said questions about reading could be “a standing item” in checkups and he hoped the society’s statement to medical professionals who care for children “enhances their confidence in being a strong advocate for the child” while spurring partnerships with others involved in a child’s life such as teachers and psychologists.
The guidance said pediatricians also play a key role in detecting and monitoring conditions that often coexist with difficulty reading such as attention-deficit hyperactivity disorder, but McLeod noted that getting such specific diagnoses typically involves a referral to a specialist, during which time a child continues to struggle.
He also acknowledged that some schools can be slow to act without a specific diagnosis from a specialist, and even then a child may end up on a wait list for school interventions.
“Evidence-based reading instruction shouldn’t have to wait for some of that access to specialized assessments to occur,” he said.
“My hope is that (by) having an existing statement or document written by the Canadian Paediatric Society … we’re able to skip a few steps or have some of the early interventions present,” he said.
McLeod added that obtaining specific assessments from medical specialists is “definitely beneficial and advantageous” to know where a child is at, “but having that sort of clear, thorough assessment shouldn’t be a barrier to intervention starting.”
McLeod said the society was partly spurred to act by 2022’s “Right to Read Inquiry Report” from the Ontario Human Rights Commission, which made 157 recommendations to address inequities related to reading instruction in that province.
He called the new guidelines “a big reminder” to pediatric providers, family doctors, school teachers and psychologists of the importance of literacy.
“Early identification of reading difficulty can truly change the trajectory of a child’s life.”
This report by The Canadian Press was first published Oct. 23, 2024.
